Feeling Great After Targeted Lung Cancer Treatment

When Finest Johnson visits the TriHealth Cancer Institute at Good Samaritan Hospital, he doesn’t take the elevator. He prefers climbing the stairs— from basement parking up to the 4th floor without stopping to catch his breath. It’s a challenge the lung cancer survivor does to keep his lungs healthy. It’s also a reminder of how far he’s come since his diagnosis three years ago.

In 2015, Finest, 46, had a chronic cough he attributed to dust exposure at his job as an automotive assembly technician. Visits to his doctor yielded diagnoses of bronchitis and asthma with prescriptions for medications and an inhaler. After fatigue and headaches set in, Finest’s mother, Barbara Johnson, RN, an infusion nurse at TriHealth Cancer Institute, insisted he get an X-ray.

An initial X-ray showed a suspicious mass in the lungs and a follow-up scan and biopsy at Good Samaritan Hospital confirmed stage 4 lung cancer. According to Finest, father to Finest Jr., 23, and Christiana, 16, “A full body scan showed the cancer had spread. There was a tumor in my brain as well.”

Multidisciplinary Team Takes Action

David J. Draper, MD, a medical oncologist, took charge. “He was the first person to see Finest and got the ball rolling, organizing tests and referring him to specialists,” says Barbara.

An expert multidisciplinary team was swiftly assembled. It included Andrew Parchman, MD, a medical oncologist with expertise in innovative lung cancer treatment, as well as neurosurgeon Christopher McPherson, MD, and radiation oncologist Daniel White, MD.

“As we’ve come to better understand what causes cancer, treatment has become much more complex,” says Dr. Parchman. “We take a multidisciplinary approach to care. At our clinic, patients meet with specialists—a medical oncologist, thoracic surgeon, pulmonologist, radiation oncologist, pharmacist, oncology nurse navigator and genetic counselor—who review their case as a team. We examine images and biopsy and genetic results and create a personalized treatment plan that is put into action quickly.”

To combat Finest’s debilitating symptoms, Dr. McPherson performed palliative brain surgery to remove the metastasized tumor and Dr. White coordinated radiation treatments. Finest received radiation to his lungs and stereotactic radiosurgery (a form of radiation therapy that focuses high-dose energy on a precise area with fewer side effects) to his brain.

“At TriHealth Cancer Institute, I had the best team,” says Finest, calling out radiation therapists who supported him during difficult radiation sessions and his nurse who helped him prepare Family and Medical Leave Act (FMLA) paperwork.

“I was determined to return to work,” he says.

Precision medicine was in its infancy 10 years ago. Today, TriHealth augments chemotherapy with targeted therapies that focus on specific genes or proteins to combat cancer, and with immunotherapy, which stimulates the body’s immune system to join the fight.

Genetic testing discovered that Finest’s tumor had a mutation of the ALK (Anaplastic Lymphoma Kinase) gene, an occurrence in 2 percent of lung cancer patients. This ALK abnormality acts as an “on switch” to cancer. The genetic results meant Finest was eligible for targeted drug therapy that could turn the ALK mutation switch off.

Finest was prescribed an ALK inhibitor called crizotinib. “It’s a pill that rapidly shrinks the cancer and is effective at holding it at bay,” says Dr. Parchman.

When Finest experienced side effects, a new plan was put into action. “Science is moving so fast that a second medication, alectinib, was approved by the FDA while Finest was on the first drug.” Alectinib has proven effective at subduing Finest’s cancer, without any negative consequences.

“There’s a lot of hope,” says Dr. Parchman about the future of cancer treatment. “Here’s a young guy, a non-smoker, who works hard, is raising his kids and cancer hits him out of the blue. His response to treatment has been remarkable. His symptoms have disappeared and his cancer is under control.”

Back on the Playing Field

For TriHealth oncology staff who know and respect their longtime colleague Barbara Johnson, her son’s cancer experience hit close to home. “But it also energized us as a team because we saw how far we’ve come with lung cancer treatment and how effective we’ve been at getting Finest back to his life,” says Dr. Parchman.

These days, Finest is feeling great, working full-time and enjoying time with family and friends. They rallied around him this summer when Finest took to the pitcher’s mound at a Cincinnati Reds baseball game. It’s a moment he’ll long remember. “I threw the first pitch and Dr. Parchman caught it!”